[One stage surgical treatment of complex urethral strictures with a pedicled skin graft. Report of 104 cases].
The technique of one stage operations using pedicled skin grafts represent an undeniable progress in the treatment of urethral strictures. The same operator in 1984-1990 performed 104 urethroplasties by using this technique. The proposed technique, originally inspired by Orandi and Blandy was performed as surgical treatment to all of the urethral strictures encountered most often, to broaden a stenosed urethra by the use of the pedicled skin graft as a patch, for other cases, by making a tubular graft meant to replace a segment of the urethra and for 2 extreme cases to replace pratically the entire damaged urethra. The urethral strictures were of different localisations: 19 were penien, 55 were bulbar perineal, 30 were bulbar membranous. The majority of the cases were qualified as "difficult and complex urethral strictures" due to: accompanying infections and iatrogenic diseases, 31 of them were fistular stenosis, 37 were multi-operated, half of the total number of the cases suffered upstream repercussions of the stenosis, and 17 cases had an associated pathology. The author used the pedicled skin graft as a patch to broaden the stenosed urethra on 91 patients, made a tubular graft to replace a segment of the urethra for 11 patients and for 2 extreme cases, to replace practically the entire urethra. Follow-up for half of the cases operated extended up to 2 years, the longest being up to 5 years, showed that 96% of the patients were satisfied. The criteria used for judging the quality of the results were clinical, radiographic and endoscopic.(ABSTRACT TRUNCATED AT 250 WORDS)
Falandry
L
L
Service d'Urologie, Centre Hospitalier Universitaire de Libreville, Gabon.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012008:Recurrence; D013524:Surgical Flaps / Q000379:methods*; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000601:surgery*
Traitement chirurgical en un temps des rétrécissements complexes de l'urètre par implant cutané pédiculé. A propos de 104 cas.